Lutman M, Girelli G
Servizio di Radiologia, Ospedale Civile, Pordenone.
Radiol Med. 1991 Mar;81(3):225-7.
Four cases of spontaneous regression of herniated nucleus polposus are described, which were followed after conservative medical treatment. Three female and one male patients who suffered from severe lumbago were evaluated; their age ranged 24-59 years. From the first CT scan on which herniation was diagnosed to follow-up control after complete regression of symptoms an average period of 14 months elapsed. Comparing ours with literature data, a substantial agreement was observed of both timing of spontaneous regression and location (most often involved was the last lumbar intervertebral space). The age of one of our patients (59 years) is to be stressed, which is well above the mean age reported in literature (35 years). The pathogenesis of regression is still unknown. The most reliable hypothesis seems to be that of dehydration and progressive atrophy of the herniated nucleus polposus. The appearance, in some cases, of the vacuum disk phenomenon seems to support such a thesis. Therefore, the diagnosis of a herniated nucleus polposus of relatively small size, still contained in an intact posterior longitudinal ligament, widely justifies the choice of waiting tactics.
本文描述了4例经保守治疗后随访的腰椎间盘突出症自然消退病例。评估了3名女性和1名男性患者，他们均患有严重腰痛，年龄在24至59岁之间。从首次诊断出椎间盘突出的CT扫描到症状完全消退后的随访控制，平均经过了14个月。将我们的病例与文献数据进行比较，发现自然消退的时间和位置（最常累及的是最后一个腰椎间隙）有很大的一致性。我们其中一名患者的年龄（59岁）值得强调，这远高于文献报道的平均年龄（35岁）。消退的发病机制仍然未知。最可靠的假设似乎是突出的椎间盘髓核脱水和进行性萎缩。在某些情况下出现的真空椎间盘现象似乎支持这一论点。因此，对于相对较小且仍包含在完整后纵韧带内的腰椎间盘突出症，诊断结果充分证明了选择等待策略的合理性。
